| NPI | 1144660903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2025-01275) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: NC 2025-01275) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2025-06-25 |